Study of Radium-223 Dichloride Versus Placebo and Treatment With Exemestane / Everolimus in Subjects With Bone Predominant HER2 (Human Epidermal Growth Factor Receptor 2) Negative Hormone Receptor Positive Metastatic Breast Cancer
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ClinicalTrials.gov Identifier: NCT02258451 |
Recruitment Status :
Active, not recruiting
First Posted : October 7, 2014
Last Update Posted : December 31, 2020
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The objective of this study is to assess efficacy and safety of radium 223 dichloride in subjects with human epidermal growth factor receptor 2 (HER2) negative hormone receptor positive breast cancer with bone metastases treated with exemestane and everolimus
After implementation of CSP Amendment 10, only a limited number of subjects will remain in this study, in order to reduce the burden to study subjects, collection of data will be reduced and will focus mainly on acute safety, SSE, and OS. Once subjects are rolled over, the long-term safety will be collected and assessed entirely in the separate extended safety follow-up study.
Condition or disease | Intervention/treatment | Phase |
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Breast Neoplasms | Drug: Radium-223 dichloride (Xofigo, BAY88-8223) Drug: Placebo (saline) Drug: Exemestane Drug: Everolimus | Phase 2 |
Study Type : | Interventional (Clinical Trial) |
Actual Enrollment : | 283 participants |
Allocation: | Randomized |
Intervention Model: | Parallel Assignment |
Masking: | Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor) |
Primary Purpose: | Treatment |
Official Title: | A Phase II Randomized, Double-blind, Placebo-controlled Trial of Radium-223 Dichloride in Combination With Exemestane and Everolimus Versus Placebo in Combination With Exemestane and Everolimus When Administered to Metastatic HER2 Negative Hormone Receptor Positive Breast Cancer Subjects With Bone Metastases |
Actual Study Start Date : | June 4, 2015 |
Estimated Primary Completion Date : | March 31, 2021 |
Estimated Study Completion Date : | March 31, 2021 |

Arm | Intervention/treatment |
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Experimental: Radium-223 dichloride + exemestane/everolimus
Up to 6 cycles of radium-223 dichloride 50kBq/kg body weight (55 kBq/kg after implementation of National Institute of Standards and Technology [NIST] update) (randomized) + All patients will receive exemestane and everolimus
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Drug: Radium-223 dichloride (Xofigo, BAY88-8223)
Up to 6 cycles of radium-223 dichloride 50kBq/kg body (55 kBq/kg after implementation of National Institute of Standards and Technology [NIST] update) Drug: Exemestane Administration of exemestane will be in accordance to the local label and/or in line with local standard of practice. Drug: Everolimus Administration of everolimus will be in accordance to the local label and/or in line with local standard of practice. |
Placebo Comparator: Placebo + exemestane/everolimus
Up to 6 cycles of saline injection (placebo) (randomized) + All patients will receive exemestane and everolimus
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Drug: Placebo (saline)
Up to 6 cycles of saline injection Drug: Exemestane Administration of exemestane will be in accordance to the local label and/or in line with local standard of practice. Drug: Everolimus Administration of everolimus will be in accordance to the local label and/or in line with local standard of practice. |
- Symptomatic skeletal event free survival (SSE-FS). [ Time Frame: From time of randomization up to 61 months ]
- Overall survival [ Time Frame: From time of randomization up to 61 months ]
- Time to opiate use for cancer pain [ Time Frame: From time of randomization up to 61 months ]
- Time to pain progression (only in subjects with baseline worst pain score (WPS) ≤8) [ Time Frame: From time of randomization up to 61 months ]
- Time to cytotoxic chemotherapy [ Time Frame: From time of randomization up to 61 months ]
- Radiological progression-free survival (rPFS) [ Time Frame: From time of randomization up to 61 months ]
- Frequency of abnormalities in laboratory examinations [ Time Frame: From time of randomization up to 61 months ]
- Pain improvement rate [ Time Frame: From time of randomization up to 61 months ]
- To measure new primary malignancies and hematopoietic reserve for tolerability of subsequent chemotherapy [ Time Frame: From time of randomization up to 61 months ]

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Ages Eligible for Study: | 18 Years and older (Adult, Older Adult) |
Sexes Eligible for Study: | Female |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Women (≥18 years of age) with metastatic breast cancer not amenable to curative treatment by surgery or radiotherapy.
- Documentation of histological or cytological confirmation of estrogen receptor positive (ER+) and HER2 negative adenocarcinoma of the breast must be available.
- Documentation of menopausal status: postmenopausal subjects or pre-menopausal subjects with ovarian radiation or concomitant therapy with a luteinizing hormone-releasing hormone (LH-RH) agonist/antagonist are eligible.
- Subjects with bone dominant disease with at least 2 skeletal metastases identified at baseline by bone scintigraphy and confirmed by computed tomography (CT)/magnetic resonance imaging (MRI).
- Subjects must have received at least one line of hormonal therapy in the metastatic setting.
- Subjects who are eligible as per the Investigator's assessment and according to the local label for treatment with exemestane and everolimus as a second line or greater of hormone therapy in a metastatic setting.
- Subjects must have experienced recurrent/progressive disease following treatment with a non-steroidal aromatase inhibitor (letrozole or anastrozole) in an adjuvant or metastatic setting
- Subjects must have experienced no more than two skeletal-related events (SREs) prior to study entry defined as: need for external beam radiotherapy (EBRT) to bone pain, pathological bone fracture (excluding major trauma), spinal cord compression and/or orthopedic surgical procedure. Subjects with no prior SREs are not permitted.
- Subjects must be on therapy with bisphosphonates or denosumab for at least 1 month before start of study treatment.
- Adequate hematological, liver and kidney function.
Exclusion Criteria:
- Subjects with Inflammatory breast cancer.
- Patients with immediately life-threatening visceral disease for whom chemotherapy is preferred treatment option.
- Subjects who have either received chemotherapy for metastatic disease or are considered by the treating investigator to be appropriate candidates for chemotherapy as current treatment for metastatic breast cancer are excluded. Chemotherapy administered for adjuvant/neo adjuvant disease is acceptable provided it was administered at least 1 year prior to study entry.
- Subjects who received prior treatment or are already receiving everolimus treatment prior to study entry are not eligible.
- Subjects with known or history of brain metastases or leptomeningeal disease: subjects with neurological symptoms must undergo a contrast CT scan or MRI of the brain within 28 days prior to randomization to exclude active brain metastasis. Imaging of the central nervous system (CNS) is otherwise not required.

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02258451

Study Director: | Bayer Study Director | Bayer |
Responsible Party: | Bayer |
ClinicalTrials.gov Identifier: | NCT02258451 |
Other Study ID Numbers: |
17096 2014-002114-23 ( EudraCT Number ) |
First Posted: | October 7, 2014 Key Record Dates |
Last Update Posted: | December 31, 2020 |
Last Verified: | December 2020 |
Studies a U.S. FDA-regulated Drug Product: | Yes |
Studies a U.S. FDA-regulated Device Product: | No |
Breast Cancer |
Breast Neoplasms Neoplasms by Site Neoplasms Breast Diseases Radium Ra 223 dichloride Skin Diseases Everolimus Exemestane Antineoplastic Agents Immunosuppressive Agents |
Immunologic Factors Physiological Effects of Drugs Aromatase Inhibitors Steroid Synthesis Inhibitors Enzyme Inhibitors Molecular Mechanisms of Pharmacological Action Estrogen Antagonists Hormone Antagonists Hormones, Hormone Substitutes, and Hormone Antagonists |